Varenicline reduces post-quit smoking relapses

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1. Smokers randomized to varenicline plus counseling were more likely to abstain from smoking six months after quitting compared to those receiving placebo plus counseling. 

2. Patients randomized to varenicline reported fewer negative emotional effects compared to placebo group. 

Participants receiving varenicline plus counseling relapsed less frequently than those on placebo. In contrast to reports associating varenicline with an increased risk of neuropsychiatric events, patients randomized to varenicline reported fewer negative emotional effects. These results suggest varenicline may help smokers quit more successfully and have a better experience while doing so.

This study lacked the power (n=259) to detect a difference between varenicline and bupropion treatment groups. Verified outcome ascertainment of both abstinence (biochemical testing in addition to self-report) and emotional functioning (weekly assessments) are a strength. Follow-up investigation in a larger sample size with longer-term follow-up would provide insight intervention effectiveness.

Click to read the study in JAMA Psychiatry

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1. Smokers randomized to varenicline plus counseling were more likely to abstain from smoking six months after quitting compared to those receiving placebo plus counseling. 

2. Patients randomized to varenicline reported fewer negative emotional effects compared to placebo group. 

This [randomized controlled] trial assessed the effectiveness of varenicline and buproprion on smoking cessation and post-cessation symptoms in 294 volunteers. Participants were randomized by sex, ethnicity, history of depression, and baseline smoking rate into one of three groups: placebo plus in-person and phone call counseling (n=106), varenicline plus counseling (n=86), and bupropion plus counseling (n=102). Smoking abstinence was assessed at 10 weeks, 3 months, and 6 months post-quit; affective symptoms were recorded at weekly counseling sessions during the 12-week drug treatment phase.

At the 6-months post-quit, participants on varenicline were less likely to relapse (smoke for ≥7 days or smoke ≥1 cigarette for two consecutive weeks) than the placebo group (OR: 2.85, CI: 1.47-5.51) or bupropion group (OR: 1.73, CI: 0.93-3.21). Compared to placebo group participants, varenicline group participants reported lower depression and sadness levels, decreased smoking-related psychological reward, improved concentration, and reduced cravings.

In sum: Participants receiving varenicline plus counseling relapsed less frequently than those on placebo. In contrast to reports associating varenicline with an increased risk of neuropsychiatric events, patients randomized to varenicline reported fewer negative emotional effects. These results suggest varenicline may help smokers quit more successfully and have a better experience while doing so.

This study lacked the power (n=259) to detect a difference between varenicline and bupropion treatment groups. Verified outcome ascertainment of both abstinence (biochemical testing in addition to self-report) and emotional functioning (weekly assessments) are a strength. Follow-up investigation in a larger sample size with longer-term follow-up would provide insight intervention effectiveness.

Click to read the study in JAMA Psychiatry 

By Caroline Huang and Leah Hawkins

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